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Recanalization of arterial occlusions with a lensed fiber and a holmium:YAG laser
Author(s) -
White Christopher J.,
Ramee Stephen R.,
Collins Tyrone J.,
Mesa Juan E.,
Paulsen Daniel B.,
Murgo Joseph P.
Publication year - 1991
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.1900110308
Subject(s) - holmium , laser , medicine , perforation , arterial dissection , angioplasty , materials science , dissection (medical) , nuclear medicine , surgery , radiology , optics , physics , punching , metallurgy
Laser recanalization of totally occluded swine iliac arteries was performed to assess the safety and efficacy of a lensed fiber laser angioplasty system with a holmium:YAG (2.1 μm) laser. Silica lenses of 1.0 mm, 1.3 mm, and 1.5 mm in diameter attached to the distal end of a 300‐μm diameter silica fiber delivered fluences of 79.5 J/cm 2 , 31.4 J/cm 2 , and 25.5 J/cm 2 , respectively. The pulse duration of the laser was 250 μsec and the repetition rate was 4 Hz. The mean length of the total occlusions was 5.3 ± 2.0 cm (range 0.5 cm to 8.0 cm). Successful recanalization was obtained in 16/16 lesions without angiographic vessel perforation. Angiographically significant residual stenoses (>50%)remained in every case following successful laser recanalization. Histologically there was minimal evidence of thermal or acoustic tissue injury; however, in 4 of 16 arteries there was evidence of deep arterial dissection following laser recanalization. We conclude that this lensed fiber coupled with a holmium:YAG laser is a safe and effective method for crossing total occlusions in the relatively straight iliac arteries of this animal model.